Schools use skits to fight hepatitis A HANDY LESSONS

The second-graders sat in rapt attention as the drama unfolded, performed by a pair of infection-control nurses with colorful hand puppets at General Wolfe Elementary School near Fells Point.

The white puppet, "Annie," was late for breakfast, and almost had forgotten to wash her hands that morning.

Luckily, she'd remembered after all -- because "Germie" was lying in wait, a horned, green meanie ready to spread germs that could make Annie's head hurt or her stomach ache.

And when the show was over, the children dutifully trooped to the classroom sink to practice washing their hands, under the nurses' watchful eyes.

It was all part of a new Baltimore school effort to combat the spread of hepatitis A, a contagious liver disease, and other infections that can be prevented by proper hand washing.

State health officials report 775 cases of hepatitis A statewide so far this year, including 512 in Baltimore, 137 in Baltimore County and 47 in Anne Arundel County.

That comes on the heels of 1,200 cases statewide last year, which was a dramatic increase over the 307 cases reported in Maryland in all of 1988.

Much of last year's increase took place in the Baltimore metropolitan area, including Baltimore and Anne Arundel counties, according to a state report.

The special school health education program was suggested by a group of hospital nurses specializing in infection control who are providing their expertise.

It will will bring a special puppet show and educational workshop to 37 city schools in areas that have had problems in the past with hepatitis A infection.

The program focuses on one of the simplest and most basic hygiene precautions -- hand washing.

Public health experts say that simply washing one's hands after using the toilet and before eating or preparing food can help prevent fecal-bourne diseases such as hepatitis A and other infections.

"If you get germs on your hands, they're going to get from your hands into somebody else's mouth or on somebody else's food," said Richard W. Dunning, an epidemiologist with the Baltimore health department. "By hand washing, you can eliminate this."

Unfortunately, "a lot of the basics are not emphasized at home," said Patricia Coughenour, a school nurse who visits General Wolfe school once a week. "That's why the school needs to do this."

"They know what I taught them," said second-grade teacher Maria Gonzalez. "I told them they need to get both the back side and the front side. Get in between the fingers. Make sure you use lots of soap."

The program includes a segment in which teachers discuss the link between germs and illness.

The puppet show then emphasizes the importance of hand washing, and is followed by a demonstration of proper hand washing techniques, including an actual practice session if possible.

The program will be offered at elementary schools between now and December in the following zip code areas: 21202 (downtown), 21215 (Northwest Baltimore), 21217 (West Baltimore), 21218 (Northeast Baltimore), and 21223 (Southwest

Baltimore).

It proved popular with the children in Gonzalez's second grade class yesterday.

Grace Thompson, a seven-year-old, said that she learned about "talking care of our hands by washing them and drowning the germs." Echoing a theme highlighted by the nurses, she said "we are going to be 'germbusters.' "

And, lest anyone get the wrong idea, Thompson insists that she always washes her hands at home.